Medicare Boot Camp - Utilization Review Version
HIM-HIPAA Insider, June 23, 2014
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Due to popular demand, we’ve added another Medicare Boot Camp®—Utilization Review Version!
- Executives, CMOs, VPMAs: Learn how to build an effective UR committee and ensure physician advisors are ready to implement the new rules
- UR committee members and physician advisors: Get the information you need to make decisions regarding patient status that will be compliant while not leaving any money on the table.
- Compliance officers: Get a complete understanding of the UR rules so that you can ensure your facility is in compliance.
- Nurse administrators/case managers: Understand the details of the rules so that you can educate physicians on them.
- Revenue cycle staff: Learn how managing patient status plays a critical role in correct reimbursement, and can stabilize inpatient reimbursement.
- How to apply the 2-midnight benchmark and 2-midnight presumptions
- The importance of continued monitoring of physician practice patterns
- The advantages of post discharge versus concurrent patient status reviews
- When self-denial is appropriate to take advantage of Part B payment for an inpatient case
- How NCDs, LCDs, and CEDs affect coverage of cases that meet the 2-midnight benchmark
- The observation coverage rules and how they interact with the new benchmark
- When ABNs should be used for extended stays that don’t meet medical necessity
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